Family Planning Programs and the Health and Fertility of US Women, 1960-1980

In 1999, the United States Center for Disease Control (CDC) named family planning as one of the top ten "Great Public Health Achievements" of the 20th century. However, the lack of data and credible estimation strategies have limited social science knowledge about the benefits of these programs. Dramatic increases in federal investments in U.S. family planning programs under the War on Poverty (1964-1970) and Title X of the Public Health Service Act (1970-1980) present an unrealized opportunity to evaluate the importance of these programs. This project will exploit discontinuities in federal family planning grants from 1964 to 1980 to create new estimates of these programs' impact on U.S. fertility and maternal and infant health.

This project has four specific aims: (1) To compile, encode, link and disseminate the most comprehensive dataset on annual federal investments in family planning services from 1964 to 1980; fertility rates by race and county from 1950 to 1980; and maternal and infant health measures by race and county from 1950 to 1980; (2) To develop and test two alternative methodologies for estimating the benefits of family planning programs; (3) To quantify the impact of family planning programs on fertility and health outcomes; (4) To quantify the impact of family planning programs on disparities in fertility and health outcomes between racial groups, low-income and higher-income women, and between communities.

Several additional features make this project particularly novel. First, a comprehensive summary of all (not just federally funded) family planning services in five program years allows an examination of federal crowd-out. Secondly, heterogeneity in the effectiveness service delivery can be analyzed by provider type, because the clinic censuses provide information on the location (hospital or elsewhere) and sector (nonprofit or public) of each program. Finally, the 1960s and 1970s in the U.S. are a particularly useful point of comparison for understanding the effectiveness of many of these programs today as well as in developing countries. By compiling, encoding and disseminating information on the U.S. during the 1960s and 1970s, this project will aid other researchers interested in these programs, fertility and maternal and infant health during this period.